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HR shortage handicaps ARV treatment

Tue, 15 Mar 2005 12:03 AM

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South Africa's ambitious HIV/Aids treatment plan is lagging as the government struggles to plug a shortage of doctors and pharmacists and other professionals needed to battle the world's biggest HIV/Aids caseload.

For the second year in a row, the government has missed its target of providing free antiretroviral (ARV) drugs to 53 000 South Africans by March even though President Thabo Mbeki has described the programme as "the best in the world".

Only 33 000 people with full-blown AIDS were receiving free drugs at the end of January, according to the health department's new AIDS supremo, doctor Nomonde Xundu.

Healthcare workers a priority

Two months after taking up the post of director for HIV and Aids at the national health department, Xundu says the priority is finding hundreds of doctors, pharmacists and dieticians to shore up the public health care system.

"The biggest challenge I would say is getting the human resource capacity up to the level where it needs to be," says Xundu.

"In the category of pharmacists, doctors and dieticians, we are struggling," Xundu told AFP.

The health department set a goal of hiring 220 doctors by March this year but only 111 have been found, she said.

Out of the 271 pharmacists needed to help roll out the world's most comprehensive anti-retroviral treatment programme, only 90 were hired and 64 out of the 136 wanted dieticians were hired, she added.

"There are not that many sitting and waiting to work in the public health system," says Xundu. "The working conditions are not very attractive" with the average annual salary for doctors at some R190 000 rand.

R4-billion allocated to roll out

The government recently allocated R4.3-billion over the next three years to enable the rollout of free anti-retrovirals and provide comprehensive treatment.

South Africa has the world's highest HIV/Aids caseloads, with 5.3 million people, or an estimated one out of five adults living with HIV and AIDS, according to UN figures.

While she laments the lack of credible figures, Xundu says the health department estimates that 5.6 million people are living with HIV and AIDS in South Africa, with the highest prevalence rate ? at 30 percent ? among young people between the ages of 21 and 29, especially women.

Lack of human resources

The government is looking at incentives to attract more health care professionals, offering for instance housing benefits for doctors who take up posts in rural areas where there are fewer medical facilities.

A non-governmental organisation, Health Systems Trust, which has been monitoring the AIDS treatment program since its launch in 2003, also concurs that the number one problem is human resources.

"We don't have the staff, the expertise to actually run the sites", says Rob Stewart, who runs the monitoring project for the Durban-based organisation.
"But we are developing it quite rapidly," he says.

Stewart says fighting HIV/Aids in South Africa has entailed "a large restructuring of health management and personnel, right through the entire system. It's really a massive undertaking".